Comparison of Complications from Radical Cystectomy between Old-Old versus Oldest-Old Patients

被引:27
作者
Comploj, Evi [1 ]
West, Jeremy [3 ]
Mian, Michael [2 ,8 ]
Kluth, Luis Alex [4 ]
Karl, Alexander [5 ]
Dechet, Christopher [1 ,3 ]
Shariat, Shahrokh F. [10 ]
Stief, Christian G. [5 ]
Trenti, Emanuela [1 ]
Palermo, Salvatore [1 ]
Lodde, Michele [1 ]
Horninger, Wolfgang [6 ,7 ]
Madersbacher, Stephan [9 ]
Pycha, Armin [1 ]
机构
[1] Cent Hosp Bolzano, Dept Urol, IT-39100 Bolzano, Italy
[2] Cent Hosp Bolzano, Div Hematol, IT-39100 Bolzano, Italy
[3] Univ Utah, Huntsman Canc Inst, Div Urol, Salt Lake City, UT USA
[4] Weill Cornell Med Coll, Dept Urol, New York, NY USA
[5] Univ Munich, Dept Urol, Munich, Germany
[6] Med Univ Innsbruck, Dept Urol, A-6020 Innsbruck, Austria
[7] Med Univ Innsbruck, Dept Pediat Urol, A-6020 Innsbruck, Austria
[8] Med Univ Innsbruck, Dept Hematol & Oncol, A-6020 Innsbruck, Austria
[9] Med Univ Vienna, Donauspital, Dept Urol & Androl, Vienna, Austria
[10] Med Univ Vienna, Dept Urol, Vienna, Austria
关键词
Elderly; Radical cystectomy; Bladder cancer; Complications; Clavien-Dindo classification; BLADDER-CANCER; AGE; COMORBIDITY; SURVIVAL; CLASSIFICATION; MORBIDITY; GENDER;
D O I
10.1159/000358731
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Introduction:The purpose of this study was to evaluate and compare complications after radical cystectomy in patients aged >= 75 years. Materials and Methods: 251 patients aged 75-95 years (median 79) underwent radical cystectomy between 2000 and 2012 at four institutions. The patients were divided into two groups: >= 75-84 years of age (group 1) versus >= 85 years of age (group 2). Comorbidities, body mass index, and complications were obtained retrospectively, except at the Central Hospital of Bolzano and Weill Cornell Medical Center, which collected data prospectively. Cancer-specific survival, overall mortality, hospital stay, clinical outcome and complications were assessed. Complications were categorized using the Clavien-Dindo classification reporting system. The mean follow-up was 21 months. Results: The median hospital stay was 17 (2-91) days. Perioperative Clavien-Dindo grade complications were seen in 24.1% (48/199) of group 1 patients and 19.2% (10/52) of group 2 patients (p = 0.045). 30- and 90-day mortality was 4.5 and 13.5% in group 1 and 6.5 and 32.3% in group 2, respectively. Only the 90-day mortality rate was statistically significant (p < 0.05) between the two groups. The 3-year overall survival was 40% in group 1 and 34% in group 2. The 3-year cancer-specific survival was 52% in group 1 and 50% in group 2. Conclusions: We evaluated a large series of elderly (>= 75 years) patients undergoing radical cystectomy at four institutions. Comparing patients aged >= 75-84 and >= 85 years revealed no significant difference in complications, 30-day mortality, overall and cancer-specific survival rates. Only 90-day mortality rates were significantly higher in the >= 85-year-old patients. (C) 2014 S. Karger AG, Basel
引用
收藏
页码:25 / 30
页数:6
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